Provider Demographics
NPI:1275637514
Name:ASSOCIATES IN CARDIOVASCULAR MEDICINE PC
Entity Type:Organization
Organization Name:ASSOCIATES IN CARDIOVASCULAR MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ASSOCIATES IN CARDIOVASCU
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:KAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-489-1132
Mailing Address - Street 1:1215 NEW LITCHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790
Mailing Address - Country:US
Mailing Address - Phone:860-489-1132
Mailing Address - Fax:860-489-0434
Practice Address - Street 1:1215 NEW LITCHFIELD ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790
Practice Address - Country:US
Practice Address - Phone:860-489-1132
Practice Address - Fax:860-489-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT063073201207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060001344Medicare PIN
CT060001454Medicare PIN
CT470000018Medicare PIN
CTC01007Medicare PIN
CT110004479Medicare PIN
CT110004478Medicare PIN